Carter report: Hospitals face new limits on underused land

Carter recommends hospitals be ordered to operate with no more than 35 per cent non-clinical floor space and 2.5 per cent unoccupied or underused space

DH should set up “invest to save energy fund” to cut down on power bills

All trusts must be at average or above levels for estates and facilities costs by April 2017, the Labour peer says

Hospitals should be ordered to operate with no more than 35 per cent non-clinical floor space and 2.5 per cent unoccupied or underused space, Lord Carter is expected to recommend.

The Labour peer’s Department of Health sponsored review of hospital efficiency is set to suggest that this could help wring £1bn of efficiency savings out of hospital estates and facilities.

HSJ understands the draft of his soon to be published report recommends trusts should have a plan for achieving the two targets by April 2017 - and should hit them by April 2020.

A further expected recommendation is that all trusts operate at or above the average benchmarks for estates and facilities costs by April 2017, with these benchmarks set by NHS Improvement in April 2016.

The calculations were made based on a cohort of 32 trusts, some of which have private-finance arrangements, mandating fixed prices for some capital and facilities management costs.

The report is expected to criticise the accuracy of the estates returns information collection (ERIC), an annual return made by trusts to the Health and Social Care Information Centre, and to recommend trust directors work to improve their submissions.

The 2014-15 ERIC data, covering all trusts, showed 90 per cent of NHS estate counting as “occupied floor area”. It showed “unutilised space” totalling 4.5 per cent of the total.

Lord Carter’s team has estimated 7.2 per cent of trusts’ £500m annual energy bill could be saved if all organisations moved to the median and reduced consumption.

They calculated a further £89m could be saved if trusts were able to invest in combined heat and power units and other energy management systems. The team recommended the Department of Health establish an “invest to save energy efficiency fund” with Salix Finance or others.

By using publicly available data, HSJ has been able to closely match the methodology used by Lord Carter to produce trusts’ headline “savings opportunity” figures. Here we list the least and most efficient trusts according to the headline measure, as well as data for all trusts.